Billing code 27487: Knee revisionMedicare rate & RVUs in Guam
Reports revision of a total knee replacement involving replacement of both femoral and tibial components, whether or not the patellar component is revised.
CMS doesn’t publish an office rate for 27487 in Guam.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 27487 covers
An orthopedic surgeon performs this operation to revise a failed total knee replacement, replacing both the femoral and tibial components. Common clinical reasons for revision include loosening, wear, instability, or infection involving the prosthesis. The patellar component may also be revised or may remain in place. The service is typically performed in an operating room, often in a hospital facility.
Report this code when the operative record supports replacement of both the femoral and entire tibial components; replacement of only one component points to the related single-component revision code. Documentation should identify the existing knee prosthesis, the reason for revision, and the components removed and replaced. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
27487 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $1,564.91 |
How the 27487 rate is calculated
Each of 27487’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 27487
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 26.43Practice expense 15.11Malpractice 5.60
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27487
27487 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27487
Knee revision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 27487
Knee revision
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
27487 without 50 · national facility
$1,574.52
Knee revision
27487-50 · Bilateral: 150%
$2,361.78
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
27487 compared with similar codes
Compare codes
27487 vs 27486 vs 27447 vs 27488: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27486Knee revision
- Choose 27487 when both the femoral and entire tibial components are replaced. Choose 27486 when revision replaces only one component.
- 27447Total knee replacement
- 27447 describes primary total knee arthroplasty. This code is for revision of an existing total knee replacement with replacement of both femoral and tibial components.
- 27488Knee prosthesis removal
- 27488 is for removing a knee prosthesis without replacing it. Use this code when the revision includes replacement of both femoral and tibial components.
27487 billing questions
When should I report this instead of 27486?
Use this code when the revision replaces both the femoral and entire tibial components. A revision limited to one component is reported with 27486.
Can the patellar component remain in place?
Yes. The femoral and tibial component replacement defines the service; the patellar component may be revised or retained.
Can removal of the old components be billed separately?
Removal performed as part of replacing both components is part of the revision service. Code 27488 is for removal of a knee prosthesis when removal, rather than replacement, is performed.
What documentation supports the component selection?
The operative report should state the reason for revision and identify the femoral and entire tibial components removed and replaced. It should also clarify whether the patellar component was revised or retained.
How does the 90-day global period affect postoperative billing?
The global period includes the day-before preoperative visit and 90 days of related postoperative care. Those related services are included in the surgical global package.
How is bilateral reporting handled?
When the procedure is performed bilaterally and reported with modifier 50, CMS pays it at 150%. The standard same-session multiple-procedure reduction may also affect other procedures on the claim.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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